Will the Texas ED RN become a scapegoat in the Ebola patient discharge?

Published

I am sure you have all read about the Texas Ebola patient's erroneous discharge from the ED. All of the articles I've read allude to the RN as being the major cause of this error. I am very concerned that he/she will become the sacrificial lamb to pin the blame on and have negative consequences for this nurse rather than being a systems' issue. Since Ebola is such a hot issue and concern shouldn't casefinding be the responsibility of all the professionals who encounter any patient when they enter the healthcare system?

As nurses we are definitely trained in PPE. If a nurse uses PPE for something that we commonly see and care for, wouldn't a nurse use PPE for Ebola? It makes me sad that everybody's first assumptions is that she breached protocol. I'm betting she was very cautious about everything she was doing for her patient. Instead of focusing on the nurse there needs to be more focusing on learning more about Ebola. People just want to cover their butts and put the blame on anybody else that they can.

Up Vote Up Vote ×
Specializes in Critical care, tele, Medical-Surgical.

Nurses Reject 'Scapegoat' Accusations After CDC Head Blames 'Protocol Breach' for Dallas Nurse Infection of Ebola

Nurses and other healthcare experts have rejected the accusation by Centers for Disease Control and Prevention director Dr. Thomas Frieden that a "protocol breach" led to the infection of a Dallas nurse from Ebola, arguing that there should be no "scapegoats" made during a troubling situation like this.

"You don't scapegoat and blame when you have a disease outbreak," said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, according to Reuters on Monday. "We have a system failure. That is what we have to correct."...

... Healthcare and infection control experts in the U.S. have reportedly said that hospital staff need to be coached through the proper stages of treating Ebola patients, however, responding to Frieden's comments...

...Castillo noted a lack of organization and said that hospitals often "post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert."

Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also spoke out against blaming the infected nurse for the incident.

"I think that is just wrong," said Macgregor-Skinner, who has helped the Nigerian government train healthcare workers in proper Ebola outbreak response.

"We haven't provided them with a national training program. We haven't provided them with the necessary experts that have actually worked in hospitals with Ebola," he added about American nurses...

http://www.christianpost.com/news/nu...-ebola-127957/

Up Vote Up Vote ×

sounds like this is the protective wear(contact isolation) that was used in Texas for several days. This what was said on NBC Nightly News tonight "flimsy" protective wear.

Up Vote Up Vote ×
Specializes in CRNA, Finally retired.

Silly little ole me assumed that nurses who worked with these patients would be given space suits, which are commonly used in the OR's during total joint sx. I would never not take care of an ebola patient but would insist on spacesuit. Is there anything illogical about what I'm say? I'm not an ID person but am curious if requesting space suits would be "overreacting". I'm not getting a warm and fuzzy feeling about the CDC. Did anyone see Frontline on Tuesday night about antibiotic resistance. The FDA was warned about the cross-resistance possibility from livestock animals to humans, but caved under the pressure from the agri-business lobby. However, the FDA chief from 40 years ago is still alive and his theory has been vindicated. The second half of the show was devoted to a superbug which infested the ICU of the NIH. The death rates were high. Months after these patients died, the "kpc" bacterium started showing up in patients in other units who had no common factors with patients who had died months earlier in the ICU.

If I were super-rich, I'd be getting all my meat from Europe.

Up Vote Up Vote ×

Why would you have an EMR where nurses triage notes are not in same system as physician notes. Lack of communication between doctors and nurses always causes problems. Shame on the hospital for trying to blame the nurse. The physician is responsible for diagnosis and treatment plan. He sent the patient home! He chose not to read the triage notes.Probably never does read them. The hospital is responsible for the inadequate EMR system. Reading the previous post looks like they were told this would cause a problem in patient care and did not listen. Now we know they also failed to provide proper training and protective gear to the staff. The CDC told a nurse with recent exposure and a fever she could get on a commercial airplane. Even when the knew there was a problem with isolation protocol at that hospital and said they expected more hospital staff could get Ebola. There is plenty of high level poor decision making. Stop blaming the care givers! This hospital and The CDC have lost credibility. I am glad to see nurses speaking up for their colleagues.

Up Vote Up Vote ×
Specializes in All areas of Critical Care, ED, PACU, Pre-Op, BH,.

I am sick of the nurse getting thrown under the bus. We know the ED physician should have read her notes. However, the most common question of an individual coming to an ED with a fever and other symptoms would be: "have you traveled outside of the country?" Why didn't the physician ask that? The media, the public and even other nurses/physicians are throwing this nurse under the bus. We all know, nurses do not discharge patients from the ED! Only the physician or PA/NP would have been able to do that. When Mr. Duncan came to the Texas ED the first time, he was not properly treated. Accept this. The nurse did not have the authority to TREAT him. Only document her findings in her triage note.

Up Vote Up Vote ×
Specializes in All areas of Critical Care, ED, PACU, Pre-Op, BH,.

she more than likely had been vomiting and having diarrhea. She more than likely had traces on her arms, legs, clothing. He helped her when she was falling. Thereby touching her. Body fluids can be anywhere on her body. I highly doubt given how sick she was (it was right before she died) she was very weak. Doubting her ability to cleanse herself properly.

Up Vote Up Vote ×

Did you see the interview today where the Texas hospital admin admitted that Nina, the first nurse to contract ebola from the pt, was given the gown/gloves/mask when she first received him, then AFTER he got a positive dx she was given the full haz-mat CDC PPE to wear? She WASN'T GIVEN THE RIGHT GEAR yet they kept saying it was a breach in protocol, that she must have contaminated herself when removing her PPE! That's TWO times the hospital has blamed a nurse when it was the HOSPITAL'S fault!

Up Vote Up Vote ×
Specializes in Family Practice, Mental Health.

If people Still want to throw the triage nurse from "Ebola Medical"under the bus, then it is the same to say:

The Physician cannot think independently and requires input from the RN.

Without the RN, the Physician is incapable of properly diagnosing a patient.

The Physician requires the RN to tell him/her what the diagnosis is.

Maybe the folks at the CDC started seeing where the trajectory of their blame game was going, and that is why they started back peddling their "blame the RN" game?

Up Vote Up Vote ×
Specializes in NICU, Trauma, Oncology.
Did you see the interview today where the Texas hospital admin admitted that Nina, the first nurse to contract ebola from the pt, was given the gown/gloves/mask when she first received him, then AFTER he got a positive dx she was given the full haz-mat CDC PPE to wear? She WASN'T GIVEN THE RIGHT GEAR yet they kept saying it was a breach in protocol, that she must have contaminated herself when removing her PPE! That's TWO times the hospital has blamed a nurse when it was the HOSPITAL'S fault!

This infuriates me because a "suspected" case of any infectious disease should be considered a real case until proven otherwise.

Up Vote Up Vote ×
Specializes in All areas of Critical Care, ED, PACU, Pre-Op, BH,.

What news station was this on? Where they admitted not having the full gear from the get go? I am so not surprised at this! How many times are hospital officials so leary to place anyone in isolation? So not surprised!

Up Vote Up Vote ×

This is why I was so annoyed when the nurse Jennifer Joseph was interviewed on CNN stating that Nina was in "full Hazmat suit" without differentiating that she was given the a "full suit" only after the diagnosis was confirmed. I think it's likely the contact occurred during those first couple of days. No one in the media has been pointing this out.

I didn't see the interview of the Texas hospital admin admitting Nina only had the (inadequate) standard gear when she first received Duncan (Sept 28 - 30 prior to positive result), but the LA Times had revealed this several days ago, before the National Nurses United statement came out.

"Did you see the interview today where the Texas hospital admin admitted that Nina, the first nurse to contract ebola from the pt, was given the gown/gloves/mask when she first received him, then AFTER he got a positive dx she was given the full haz-mat CDC PPE to wear? She WASN'T GIVEN THE RIGHT GEAR yet they kept saying it was a breach in protocol, that she must have contaminated herself when removing her PPE! " further confusing all the misinformation.

Up Vote Up Vote ×
+ Join the Discussion